In J.F.K. File, Hidden Illness, Pain and Pills

By LAWRENCE K. ALTMAN and TODD S. PURDUM

Published: November 17, 2002

WASHINGTON, Nov. 16 — The first thorough examination of President John F. Kennedy's medical records, conducted by an independent presidential historian with a medical consultant, has found that Kennedy suffered from more ailments, was in far greater pain and was taking many more medications than the public knew at the time or biographers have since described.

As president, he was famous for having a bad back, and since his death, biographers have pieced together details of other illnesses, including persistent digestive problems and Addison's disease, a life-threatening lack of adrenal function.

But newly disclosed medical files covering the last eight years of Kennedy's life, including X-rays and prescription records, show that he took painkillers, antianxiety agents, stimulants and sleeping pills, as well as hormones to keep him alive, with extra doses in times of stress.

At times the president took as many as eight medications a day, says the historian, Robert Dallek. A committee of three longtime Kennedy family associates, who for decades refused all requests to look at the records, granted Mr. Dallek's, in part because of his "tremendous reputation," said one of them, Theodore C. Sorensen, who was the president's special counsel.

Mr. Dallek is writing a biography, "An Unfinished Life: John F. Kennedy, 1917-1963," to be published next year by Little, Brown. He was allowed to examine the records over two days last spring in the company of a physician, Jeffrey A. Kelman, and to make notes but not photocopies. Their findings appear in the December issue of The Atlantic, and they discussed them in interviews with The New York Times. The new information shows how far Kennedy went to conceal his ailments and shatters the image he projected as the most vigorous of men. It is a remarkable example of a phenomenon that has been seen many times, notably in the case of Franklin D. Roosevelt.

Yet for all of Kennedy's suffering, the ailments did not incapacitate him, Mr. Dallek concluded. In fact, he said, while Kennedy sometimes complained of grogginess, detailed transcripts of tape-recorded conversations during the Cuban missile crisis in 1962 and other times show the president as lucid and in firm command.

By the time of the missile crisis, Kennedy was taking antispasmodics to control colitis; antibiotics for a urinary tract infection; and increased amounts of hydrocortisone and testosterone, along with salt tablets, to control his adrenal insufficiency and boost his energy.

The records show that Kennedy was hospitalized for back and intestinal ailments in New York and Boston on nine previously undisclosed occasions from 1955 to 1957, when he was a senator from Massachusetts, campaigning unsuccessfully for the 1956 Democratic vice-presidential nomination — and quietly planning his 1960 presidential bid.

In December 1962, after Jacqueline Kennedy complained that he seemed "depressed" from taking antihistamines for food allergies, he took a prescribed antianxiety drug, Stelazine, for two days. At other times he took similar medications regularly.

The records show that Kennedy variously took codeine, Demerol and methadone for pain; Ritalin, a stimulant; meprobamate and librium for anxiety; barbiturates for sleep; thyroid hormone; and injections of a blood derivative, gamma globulin, presumably to combat infections.

In the White House, Kennedy received "seven to eight injections of procaine in his back in the same sitting" before news conferences and other events, Dr. Kelman said.

The president had so much pain from three fractured vertebrae from osteoporosis that he could not put a sock or shoe on his left foot unaided, the records reveal. He sometimes reported waking before dawn with severe abdominal cramps.

In August 1961, the records show, Mrs. Kennedy rushed in from another room when he screamed in pain as the White House physician, Dr. Janet G. Travell, injected procaine deep into his back muscles to numb them.

While not a complete record of Kennedy's lifetime medical history, much of which remains sealed in private hospitals, the disclosures provide a broad, authoritative view.

The records are largely from Dr. Travell, a specialist in internal medicine and pain management who treated Kennedy for years before ultimately being eased aside after bitter arguments with other doctors about his care. She gathered files from before and after he became president in 1961. Kennedy's widow and brothers, Robert and Edward, donated them in 1965 to the Kennedy Library, Deborah Leff, the library's director, said, and a half-dozen scholars who sought permission to see them over the years were rebuffed.

In The Atlantic, Mr. Dallek writes that while Kennedy's secrecy can be taken as "another stain on his oft-criticized character," the records also reveal the "quiet stoicism of a man struggling to endure extraordinary pain and distress."

Senator Edward M. Kennedy said that his family abided by the committee's decision to make all judgments like releasing the medical records.

"While not aware of the exact details of my brother's medical condition," Mr. Kennedy said, "I did see the great courage he exhibited throughout his life in triumphing over illness and pain."

Dr. Kelman, a specialist in internal medicine and physiology in Collington, Md., said: "The most remarkable thing was the extent to which Kennedy was in pain every day of his presidency."